Objective: The aim was to show that Minimally Invasive total arterial revascularization for left main stem coronary artery disease, via a left anterior Mini thoracotomy using bilateral internal thoracic arteries is fe...Objective: The aim was to show that Minimally Invasive total arterial revascularization for left main stem coronary artery disease, via a left anterior Mini thoracotomy using bilateral internal thoracic arteries is feasible, reproducible and safe. Further, there has been no exclusive data or experience with minimally invasive coronary artery bypass grafting in left main stem disease. Methods: From April 2019 to March 2024, 41 patients with left main stem stenosis, left main equivalent disease and unprotected left main with triple vessel disease underwent off pump minimally invasive multivessel coronary artery bypass grafting using either in situ pedicled Bilateral Internal Thoracic arteries or Left and Right Internal Thoracic artery Y composite conduits at three centers. Bilateral Internal Thoracic arteries were harvested under direct vision. All patients had an Intra-Aortic Balloon Pump inserted via the femoral artery prior to induction of anesthesia, to prevent any hemodynamic instability, arrhythmias, and was removed following completion of the procedure in the operating room without any complications. Efficacy and outcomes were evaluated by i) Primary (MACCE)-Major Adverse Cardiac and Cardiovascular events and ii) Secondary outcome measures including total length of stay, return to full physical activity and quality of life. Mean follow-up was 1.4 years (Maximum was 2.5 years). Results: 41 patients with left main stem coronary artery stenosis, underwent total arterial revascularization using bilateral internal thoracic arteries. Left main stem stenosis was present in 29 patients, Unprotected left main stem stenosis with triple vessel disease in 7 and left main equivalence in 5 patients. In this cohort, 29 patients with only left main stem stenosis had 2 grafts each, 7 patients with left main and triple vessel disease had 3 grafts and 5 patients with left main equivalent disease had 2 grafts respectively. The average number of grafts was 2.2. One patient was converted to open sternotomy as an emergency because of hemodynamic instability and myocardial revascularization was done on cardiopulmonary bypass (2.2%). The average hospital stay was 3.7 days. Ejection fraction was 45% ± 5%. There was one mortality (2.2%) but no major morbidity. The average ICU and hospital stay was 24 ± 4 hours and 3.7 days. All patients were free from major adverse cardiac and cerebrovascular events at follow-up. Conclusions: Multivessel total arterial revascularization using left and right internal thoracic arteries, was performed via a left anterior Mini thoracotomy on patients with left main stem disease and showed that it was safe, reproducible and will help extend the armamentarium of the surgeon in minimally invasive Coronary artery bypass grafting. Concomitantly it helped enhance the potential for shorter hospital stay, increased survival, decreased morbidity, and earlier return to full activity. Furthermore, the safety, efficacy, and outcomes of minimally invasive coronary artery bypass grafting in this high-risk group evaluated by primary and secondary outcome measures have been good in this study.展开更多
It has become general for surface waters being polluted by micro organic compounds. In order to know the current pollution situation and the properties of micro organic compounds in the Changjiang River, a test was pe...It has become general for surface waters being polluted by micro organic compounds. In order to know the current pollution situation and the properties of micro organic compounds in the Changjiang River, a test was performed on micro organic compounds in the water, bottom material and fish bodies which were sampled from major city river reaches of the Changjiang River. Based on the test result, researchers described and analyzed the sorts, concentration level and distribution features of micro organic compounds. A comprehensive evaluation was conducted by adopting the method of MEG (Multimedia Environmental Goals). The study indicated that ① the water body of major city river reaches of the Changjiang River has been generally polluted. In the test, totally 12 types with 308 kinds of organic compounds were detected. The main pollutants were paraffins, PAHs and lipids; and ② micro organic pollutant content in fish bodies was generally higher than that in bottom material which is in turn higher than that in water; and ③ pollution is relatively severe in the river reaches of mid-to-large comprehensive industrial cities with fairly great TAS (Total Ambient Severity) of public health and ecological system.展开更多
选用美棉33B和泗棉3号两个叶色深浅差异明显的品种,设置氮素水平(0、120、240、360和480 kg hm-2纯氮)试验,研究棉花主茎叶SPAD值的叶位分布,对棉花进行氮素营养诊断。结果表明,棉花主茎顶部4张定型叶片的SPAD值对施氮水平反应的敏感程...选用美棉33B和泗棉3号两个叶色深浅差异明显的品种,设置氮素水平(0、120、240、360和480 kg hm-2纯氮)试验,研究棉花主茎叶SPAD值的叶位分布,对棉花进行氮素营养诊断。结果表明,棉花主茎顶部4张定型叶片的SPAD值对施氮水平反应的敏感程度存在显著差异,随施氮量增加,棉花主茎顶1、2、3、4定型叶SPAD值的大小位次发生明显变化,其中以顶1定型叶对施氮量增加的响应最为敏感,顶4定型叶最为迟钝。利用顶1定型叶与顶4定型叶SPAD值的相对差值,可较精确地诊断棉花的氮素营养水平,并能克服品种和生育时期不同的影响,是一种具有普适性的棉花氮素营养诊断指标。展开更多
文摘Objective: The aim was to show that Minimally Invasive total arterial revascularization for left main stem coronary artery disease, via a left anterior Mini thoracotomy using bilateral internal thoracic arteries is feasible, reproducible and safe. Further, there has been no exclusive data or experience with minimally invasive coronary artery bypass grafting in left main stem disease. Methods: From April 2019 to March 2024, 41 patients with left main stem stenosis, left main equivalent disease and unprotected left main with triple vessel disease underwent off pump minimally invasive multivessel coronary artery bypass grafting using either in situ pedicled Bilateral Internal Thoracic arteries or Left and Right Internal Thoracic artery Y composite conduits at three centers. Bilateral Internal Thoracic arteries were harvested under direct vision. All patients had an Intra-Aortic Balloon Pump inserted via the femoral artery prior to induction of anesthesia, to prevent any hemodynamic instability, arrhythmias, and was removed following completion of the procedure in the operating room without any complications. Efficacy and outcomes were evaluated by i) Primary (MACCE)-Major Adverse Cardiac and Cardiovascular events and ii) Secondary outcome measures including total length of stay, return to full physical activity and quality of life. Mean follow-up was 1.4 years (Maximum was 2.5 years). Results: 41 patients with left main stem coronary artery stenosis, underwent total arterial revascularization using bilateral internal thoracic arteries. Left main stem stenosis was present in 29 patients, Unprotected left main stem stenosis with triple vessel disease in 7 and left main equivalence in 5 patients. In this cohort, 29 patients with only left main stem stenosis had 2 grafts each, 7 patients with left main and triple vessel disease had 3 grafts and 5 patients with left main equivalent disease had 2 grafts respectively. The average number of grafts was 2.2. One patient was converted to open sternotomy as an emergency because of hemodynamic instability and myocardial revascularization was done on cardiopulmonary bypass (2.2%). The average hospital stay was 3.7 days. Ejection fraction was 45% ± 5%. There was one mortality (2.2%) but no major morbidity. The average ICU and hospital stay was 24 ± 4 hours and 3.7 days. All patients were free from major adverse cardiac and cerebrovascular events at follow-up. Conclusions: Multivessel total arterial revascularization using left and right internal thoracic arteries, was performed via a left anterior Mini thoracotomy on patients with left main stem disease and showed that it was safe, reproducible and will help extend the armamentarium of the surgeon in minimally invasive Coronary artery bypass grafting. Concomitantly it helped enhance the potential for shorter hospital stay, increased survival, decreased morbidity, and earlier return to full activity. Furthermore, the safety, efficacy, and outcomes of minimally invasive coronary artery bypass grafting in this high-risk group evaluated by primary and secondary outcome measures have been good in this study.
文摘It has become general for surface waters being polluted by micro organic compounds. In order to know the current pollution situation and the properties of micro organic compounds in the Changjiang River, a test was performed on micro organic compounds in the water, bottom material and fish bodies which were sampled from major city river reaches of the Changjiang River. Based on the test result, researchers described and analyzed the sorts, concentration level and distribution features of micro organic compounds. A comprehensive evaluation was conducted by adopting the method of MEG (Multimedia Environmental Goals). The study indicated that ① the water body of major city river reaches of the Changjiang River has been generally polluted. In the test, totally 12 types with 308 kinds of organic compounds were detected. The main pollutants were paraffins, PAHs and lipids; and ② micro organic pollutant content in fish bodies was generally higher than that in bottom material which is in turn higher than that in water; and ③ pollution is relatively severe in the river reaches of mid-to-large comprehensive industrial cities with fairly great TAS (Total Ambient Severity) of public health and ecological system.
文摘选用美棉33B和泗棉3号两个叶色深浅差异明显的品种,设置氮素水平(0、120、240、360和480 kg hm-2纯氮)试验,研究棉花主茎叶SPAD值的叶位分布,对棉花进行氮素营养诊断。结果表明,棉花主茎顶部4张定型叶片的SPAD值对施氮水平反应的敏感程度存在显著差异,随施氮量增加,棉花主茎顶1、2、3、4定型叶SPAD值的大小位次发生明显变化,其中以顶1定型叶对施氮量增加的响应最为敏感,顶4定型叶最为迟钝。利用顶1定型叶与顶4定型叶SPAD值的相对差值,可较精确地诊断棉花的氮素营养水平,并能克服品种和生育时期不同的影响,是一种具有普适性的棉花氮素营养诊断指标。
